本文關(guān)鍵詞： Bristol最新神經(jīng)心理量表 蒙特利爾認(rèn)知評估量表 簡易精神狀態(tài)檢查 老年癡呆　出處：《大連醫(yī)科大學(xué)》2013年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：隨著經(jīng)濟的飛速發(fā)展，中國乃至全球進入老齡化社會。人均壽命的延長以及生活質(zhì)量提高是人們不斷追求的希望。癡呆，是一種獲得性、進行性、全面性的認(rèn)知功能障礙，老年癡呆可以分為阿爾茨海默病(Alzheimer's Disease, AD)癡呆、血管性癡呆及二者并存的混合型癡呆，，而阿爾茨海默病(AD)是老年癡呆中最常見的類型，是以進行性學(xué)習(xí)記憶和認(rèn)知功能障礙為特征，最終導(dǎo)致患者生活能力喪失的一種老年性神經(jīng)退行性疾病，該病嚴(yán)重?fù)p害老年人的身心健康。已經(jīng)成為繼心臟病、腫瘤、腦卒中后第四位引起成人死亡的病因。近年來AD發(fā)病率逐漸增加，并且呈現(xiàn)年輕化趨勢。AD是一種病因不明的進行性變性疾病，發(fā)病率隨年齡的增高而增加。Bristol最新神經(jīng)心理量表中文版(BMDC-NPTB-CR)、蒙特利爾認(rèn)知評估量表(MoCA)中文版以及簡易精神狀態(tài)檢查(MMSE)都是新近應(yīng)用于臨床的關(guān)于認(rèn)知功能障礙篩查和評估的量表。研究顯示BMDC-NPTB-CR的信度和效度較高，與MoCA和MMSE比較，其敏感性和特異性都更具優(yōu)勢，但由于在國內(nèi)應(yīng)用時間較短，各地結(jié)果報道不一。本研究旨在對BMDC-NPTB-CR、MoC和MMSE在評定老年癡呆中的應(yīng)用價值做一比較，探討B(tài)MDC-NPTB-CR對早癡呆患者的篩查效果，為癡呆患者的早發(fā)現(xiàn)早治療提供參考資料。 方法：對2011年1月至2012年12月在我院老年病科神經(jīng)心理學(xué)評價室接受評定者100例老年人采用BMDC-NPTB-CR、MoCA和MMSE進行測試，以MMSE為校標(biāo)，分析三個量表的平行效度并比較認(rèn)知水平不同的老年人的測試成績。所有測試均由經(jīng)培訓(xùn)的專業(yè)人員進行，同時采集病史并給予患者體檢和神經(jīng)系統(tǒng)檢查。采用DSM-Ⅳ、CDR診斷標(biāo)準(zhǔn)判斷癡呆、可疑癡呆和認(rèn)知正常。統(tǒng)計學(xué)方法采用SPSS for windows13.0軟件包，多組均數(shù)比較采用方差分析，相關(guān)分析采用Pearson相關(guān)分析。 結(jié)果：Bristol最新神經(jīng)心理量表的Cronbach α系數(shù)等于0.784，分量表α系數(shù)介于0.773~0.825；將各分測驗量表分與量表總分進行相關(guān)性分析，相關(guān)系數(shù)r值介于0.473~0.899（P＜0.001），表明BMDC-NPTB-CR量表的內(nèi)部一致性良好；MDC-NPTB-CR總分和MoCA總分分別與MMSE總分高度相關(guān)(r分別為0.787和0.897，P＜0.05)，各分測驗量表具有顯著的相關(guān)性，表明MDC-NPTB-CR的校標(biāo)效度較好；不同認(rèn)知水平的受試者，在量表測驗中表現(xiàn)有顯著差異，表明BMDC-NPTB-CR各分測驗和量表總分可區(qū)分受試者的不同認(rèn)知水平。 結(jié)論：Bristol最新神經(jīng)心理量表中文版是信度、效度較好的標(biāo)準(zhǔn)化成套量表，可區(qū)分受試者的不同認(rèn)知水平，在測定癡呆方面相比于MMSE與MocA更能對臨床診斷做出早期準(zhǔn)確有效的判斷，能對老年癡呆及老年癡呆前期多項認(rèn)知功能進行全面、系統(tǒng)評價，適合我國臨床和科研工作應(yīng)用。
[Abstract]:Objective: with the rapid development of economy, China and even the whole world have entered an aging society. The prolongation of life expectancy and the improvement of quality of life are the hope that people are constantly pursuing. Dementia is a kind of acquired and progressive disease. Alzheimer's disease can be divided into Alzheimer's disease (AD) dementia, vascular dementia (AD) and a mixture of the two. Alzheimer's disease (AD) is the most common type of Alzheimer's disease. It is a kind of senile neurodegenerative disease characterized by progressive learning, memory and cognitive dysfunction, which ultimately leads to the loss of patients' ability to live. The disease seriously damages the physical and mental health of the elderly. It has become a follow-up to heart disease and cancer. The incidence of AD increased gradually in recent years, and showed a trend of younger age. AD is a progressive degeneration disease of unknown etiology. The incidence rate increases with age. Bristol latest Neuropsychological scale Chinese version BMDC-NPTB-CRP, Montreal Cognitive Assessment scale MoCA Chinese version and simple Mental status Test MMSE are all newly used in clinical screening for cognitive impairment. The study showed that BMDC-NPTB-CR had higher reliability and validity. Compared with MoCA and MMSE, the sensitivity and specificity of BMDC-NPTB-CRMoC and MMSE were compared. To investigate the screening effect of BMDC-NPTB-CR in patients with Alzheimer's disease and to provide reference materials for early detection and treatment of dementia patients. Methods: from January 2011 to December 2012, 100 elderly patients who were assessed in neuropsychological evaluation department of geriatric department were tested with BMDC-NPTB-CRMoCA and MMSE. MMSE was used as standard. The parallel validity of the three scales was analyzed and the scores of the elderly with different cognitive levels were compared. All the tests were conducted by trained professionals. At the same time, the history of the disease was collected, and the patients were given physical examination and nervous system examination. The diagnostic criteria of DSM- 鈪

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